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Teen depression: what you need to know

David McLean has written a fictional book based on his niece's experience with clinical depression.

“I tell her to take the dog with her. That way, she’s got a reason to come home.”

My brother’s words were an indication of his helplessness as a parent. His fourteen year old daughter, my niece, had been diagnosed with clinical depression.

It was easy enough to look into the probable causes. There was the marriage break-up, the trials and tribulations of puberty, a genetic disposition toward depression and the struggle to find one’s place in the maelstrom of peer pressure and personalities that make up school and domestic life. What was not easy was finding a solution. My niece not only took the family dog with her whenever and wherever she walked. She also took the ‘black dog’ with her whose jaws and teeth had a vice like grip on her thoughts like a malicious pit-bull.

The reality is that the incidence of adolescent depression is increasing. Research indicates that the average on-set age of depression in 1960 was thirty years or older. Today it is fifteen years or younger. The irony is that we live in an age that is far more affluent than fifty years ago. We are healthier, better educated and benefit from the advances in attitudes toward gender and race. The prevalence of depression, therefore, has people stumped.

My neighbours suggested by way of explanation that children are over-protected and are not prepared for the shock of life’s realities. This conversation took place just before they walked their children to the local primary school.

My sister suggested that it was all the violence and chaos that children were exposed to on television that was the disturbing element. But her children have viewed what she had viewed and they seemed to be fine.

We have chemical anodynes as a form of remedy. SSRIs or selective serotonin reuptake inhibitors provide a regulated dose of serotonin to the receptors in the brain. It can help restore the chemical balance. Our bodies are an upheaval of chemicals; endorphins, adrenaline, testosterone, progesterone. Imagine what an adolescent body is like as it goes through puberty. The dose needs to be constantly regulated.

A multi-disciplinary approach, however, is advocated today. Psychologists suggest a combination of medication and cognitive behavioural therapy. Having the individual talk about the problem seems like such a simple way to start. My niece, however, struggled to find someone she could relate to. The GP my brother took her to was too old. The child psychologist they saw wanted her to write notes about her feelings and place them in a postal box of thoughts. This just seemed a little too twee for my niece.

The school psychologist had my niece keep a journal. Writing about experiences can be a means of gaining perspective and placing events in sequence. Instead of being a victim to whatever life throws at you, an element of distance is achieved. The writer asserts a little more control and shapes those moments from the past which are troubling.

Having someone who is able to hear is also essential. My niece hadn’t told anyone as the black dog approached. She knew something was wrong but didn’t have the words to express it. Most medical complaints are obvious. People ask how you broke your arm when they see the cast and want to autograph the plaster. The complaint becomes part of the social interaction. “I didn’t know if people would think I was mad,” was my niece’s comment when she finally did open up about what was troubling her.

My niece still walks the dog; both of them. There is the family pet that is a lot healthier than it used to be. And there’s the black dog. It’s on a leash and muzzled. The medication, the talking, the writing and the listening have all been part of her ability to take control. She can see the approaching signs and knows how to recognize them. She has people around her who can listen and, as she says, “I can talk about it now.”

David is a teacher, actor and writer. He headed several English departments, the most unusual of which was in an Indonesian school, and he once chaired the Heads of English in Independent Schools in Victoria.

Here is a checklist where you can gauge yourself from Low to High with low meaning your rarely exhibit this symptom. The list has been derived from *Psychology: VCE Units 3 & 4 *Oxford University Press. Melbourne. Edwards, R.A.M., Blaher-Lucas, E. Moore, V., Marangio, K. & Ganino-Day, F. (2010) which is one of the texts currently being used in the VCE Psychology course.

It is worth noting that we all exhibit some of these traits at times. It is when we have multiple symptoms being exhibited continually that a concern emerges. It would be worth confiding in someone at such a time. Notice also that the symptoms fall into a range of categories – emotional, behavioural, cognitive and physical. A high recording in the ‘physical’ category could be indicative of a medical complaint. In other words, don’t jump to conclusions. Always seek advice.

SYMPTOM

Low

Medium

High

Emotional

Feeling sad or dejected

Loss of sense of humour

Anxiety

Anger

Motivational

Lack of interest

Lack of motivation or initiative

Behavioural

Less active and productive

Moving & speaking slowly

Time wasting

Cognitive

Self blame

Suicidal thoughts

Difficulty concentrating

Confusion

Physical

Headaches

Constipation

Indigestion

Telling the difference between depression and being unhappy requires self reflection. Try and suggest reasons for a ‘high’ or a ‘low’ reading. It is perfectly normal to feel disappointed and sad when experiencing a loss. In fact, it’s healthy. And when things unfold around you with which you are not satisfied, are you able to rationalize rather than get angry.

Always remember, talk to someone or find out more. Here are some web sites that may be useful.